Health Equity最新文献

{"title":"Improving Weight Bias Awareness Among Providers in the Sexual and Reproductive Health care Setting.","authors":"Monica Skoko Rodriguez, Julie A Thompson, Brigit Carter, Robin Wallace, Katie Riley, Ragan Johnson","doi":"10.1089/heq.2024.0096","DOIUrl":"10.1089/heq.2024.0096","url":null,"abstract":"<p><strong>Introduction: </strong>Provider bias against patients of higher weights can contribute to poor health outcomes and decreased quality of care and patient experience. Addressing weight stigma in sexual and reproductive health settings is important, as these encounters can often be patients' only health care touchpoint. Health care providers must be educated about the harms of weight stigma, ways to recognize and confront their biases, and how to advocate for patients of all sizes.</p><p><strong>Methods: </strong>In this quality improvement project, Planned Parenthood health center providers participated in a three-part virtual workshop to improve provider weight bias awareness and understanding using the Health at Every Size framework. Providers completed a pre- and post-survey, as well as a 3-month follow-up survey to assess changes in bias awareness and confidence in applying weight-neutral principles in care interactions.</p><p><strong>Results: </strong>Analysis of pre- and post-survey results showed significant improvements in provider awareness of bias as well as changes in implicit bias scores and confidence providing weight-neutral care.</p><p><strong>Conclusion: </strong>Educating providers about weight contributes to equity of care for patients of higher weights. Formal education such as workshops have the potential to reduce the harms of weight stigma in health care as changing attitudes and confidence are a precursor to behavior change. Research is needed to assess ideal education modalities and whether receiving care from weight bias-prepared providers affects patient outcomes and experiences.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"461-468"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial (In)Equity in South Los Angeles-Community Centered Experiences with COVID-19 Syndemics.","authors":"Dilara K Üsküp, Yelba M Castellon-Lopez, Oluwadamilola Jolayemi, Cheryl A Branch, Oladunni Adeyiga, Steve Shoptaw","doi":"10.1089/heq.2023.0188","DOIUrl":"10.1089/heq.2023.0188","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze community experiences involving COVID-19 vaccination access and equity in Black and Latina/o/x communities within South Los Angeles, using a socioecological framework.</p><p><strong>Methods: </strong>We conducted four virtual focus groups (<i>n</i> = 33 total participants) in 2021, with Black and Latina/o/x community members, community leaders, and community-based providers in South Los Angeles, a region highly impacted by the COVID-19 pandemic. We used a grounded theory approach to guide the analysis and generate data shaped by participant perspectives.</p><p><strong>Results: </strong>Participants across groups consistently emphasized medical mistrust, fear/skepticism, misinformation, accessibility, and feelings of pressure and blame as factors influencing COVID-19 vaccination decisions. The need to address pandemic-related socioeconomic hardships in underresourced communities was equally highlighted.</p><p><strong>Conclusions: </strong>Findings show that building trust, providing tailored information, and continued investment into diversity and equity initiatives can support Black and Latino/a/x communities in making informed health decisions. Community-centered support services should address the economic, social, and structural impact of the pandemic on vulnerable communities. Furthermore, public health and policy efforts must prioritize funding to equip social and health care systems with infrastructure investment in racial and ethnic minority communities.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"446-454"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Centering Equity and Fostering Stakeholder Collaboration and Trust-Pillars of the Maternal Health Innovation Program in Maryland.","authors":"Andreea A Creanga, Briana Kramer, Carrie Wolfson, Meighan Mary, Elizabeth M Stierman, Sarah Clifford, Ada Ezennia, Jane Rhule, Nina Martin, Maxine Vance-Reed, Teneele Bruce, Bonnie DiPietro, Adriane Burgess, Nicole Warren, Shari N Lawson, Sarah Meyerholz, Kelly Bower","doi":"10.1089/heq.2023.0127","DOIUrl":"10.1089/heq.2023.0127","url":null,"abstract":"<p><strong>Objective: </strong>To describe two main pillars of the Maryland Maternal Health Innovation Program (MDMOM): (1) centering equity and (2) fostering broad stakeholder collaboration and trust.</p><p><strong>Methods: </strong>We summarized MDMOM's key activities and used severe maternal morbidity (SMM) surveillance and program monitoring data to quantify MDMOM's work on the two pillars. We developed measures of hospital engagement with MDMOM (participation in quality improvement [QI] activities, participation in check-in meetings, staff involvement) and with other partners (participation in QI activities, representation in state-level groups). We examined Bonferroni-adjusted correlations between these hospital engagement measures and with key hospital characteristics: level of maternity care, annual delivery volume, and SMM rate.</p><p><strong>Results: </strong>Over 100 national and state organizations and individual stakeholders contributed to our building the MDMOM program and implementing key activities centering equity: hospital-based SMM surveillance in 20 of Maryland's 32 hospitals; almost 5,000 trainings offered to perinatal health care providers; two telemedicine/telehealth interventions; training of home visitors and community-based organization staff. Birthing hospitals represent MDMOM's main implementation partners. The strength of their participation in MDMOM QI activities is positively correlated to their participation in check-in meetings and with the degree of involvement by physicians in such activities. Higher engagement in MDMOM QI activities is also positively correlated to hospitals' participation in other state-level maternal health initiatives or groups.</p><p><strong>Conclusion: </strong>Our experience with the MDMOM program demonstrates that an equity focus and broad stakeholder collaboration building strong relationships and providing implementation support can lead to high levels of engagement in innovative maternal health interventions.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"406-418"},"PeriodicalIF":2.6,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Implementation of a Doula Grant Program Directed at Families from Economically Vulnerable Backgrounds: A Process Evaluation.","authors":"Samantha Wall, Kailey Snyder, Becky Baruth, Kara Foster","doi":"10.1089/heq.2023.0264","DOIUrl":"10.1089/heq.2023.0264","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the process and overall feasibility of a doula grant program for expectant families from economically vulnerable backgrounds.</p><p><strong>Design: </strong>A mixed-methods process evaluation framework was utilized to examine program feasibility and focused on constructs related to fidelity, dose delivered/dose received, reach, program satisfaction, and limited efficacy testing.</p><p><strong>Measures: </strong>Evaluation constructs were measured using a program tracking document. Program satisfaction and efficacy were examined through a mixed methodology approach utilizing doula surveys and birthing parent interviews.</p><p><strong>Analysis: </strong>Related to survey data, analysis focused on presenting descriptive counts and percentages related to the number of doulas that participated and clients served. Continuous variables were calculated as means and standard deviations and categorical data as counts and percentages. Qualitative data analyses were conducted using a structured deductive thematic approach.</p><p><strong>Results: </strong>The grant program was successfully implemented over an 18-month period, and the program had a high rate of fidelity to the grant processes developed by a Midwestern-based nonprofit organization. The program was satisfactory to doulas and parents, and the largest barrier was communication. A high incidence of prenatal anxiety among the birthing parents was reported. Thematic findings from the birthing parent interviews included the following: the grant application process was effective and easy, birth doulas were greatly valued, and a financial burden was lifted.</p><p><strong>Conclusion: </strong>This grant process can be replicated by other organizations seeking to fill a gap between doula services and the economically vulnerable.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"437-445"},"PeriodicalIF":2.6,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Concept Mapping to Identify Community Partners' and Researchers' Perceptions of Social Justice: A Path Toward Eliminating Chronic Disease Disparities.","authors":"Eric K Soule, Dina M Jones, Nakita Lovelady, Luke Thomas, Ruofei Du, Theresa E Prewitt, Elizabeth Taylor, Sydney Baker, Mignonne C Guy, Carol E Cornell, Pebbles Fagan","doi":"10.1089/heq.2023.0230","DOIUrl":"10.1089/heq.2023.0230","url":null,"abstract":"<p><strong>Background: </strong>A social justice framework can be used to inform healthy equity-focused research, and operationalizing social justice can inform strategic planning for research and practice models. This study aimed to develop a working definition of social justice based on input from a diverse group of collaborators to better inform the work conducted within the Center for Research, Health, and Social Justice.</p><p><strong>Methods: </strong>A concept mapping study was conducted from March to May 2022. A prompt designed to elicit social justice themes was developed (phase 1). At a study website, participants brainstormed statements that represented their definition of social justice (phase 2). Participants then sorted statements based on similarity and rated statements on importance (phase 3). Multidimensional scaling and hierarchical cluster analysis were used to identify nonoverlapping thematic clusters of statements (phase 4). Models were reviewed for best fit, and clusters were assigned names based on theme (phase 5).</p><p><strong>Results: </strong>Participants (<i>n</i> = 49) generated 52 unique statements that were sorted into 5 clusters describing social justice themes. Clusters included (1) Empathy, Awareness, and Understanding (<i>n</i> = 11); (2) Education and Systems Change (<i>n</i> = 10); (3) Policy Design and Implementation (<i>n</i> = 9); (4) Equity and Leveling the Playing Field (<i>n</i> = 11); and (5) Access to Services and Fair Living Standard (<i>n</i> = 11). High mean cluster ratings ranging from 5.22 to 6.02 out of 7 indicated all clusters were rated as being very important aspects of social justice.</p><p><strong>Conclusions: </strong>These data can guide the restructuring of research ecosystems that help eliminate race- and place-based health disparities.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"426-436"},"PeriodicalIF":2.6,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Health Equity in Partnership with Children's Mental Health Organizations: Considerations Before the Implementation of Parenting Programs.","authors":"Meghan Kenny, Rob Raos, Fatima Ahmad, Andrea Gonzalez","doi":"10.1089/heq.2023.0143","DOIUrl":"10.1089/heq.2023.0143","url":null,"abstract":"<p><strong>Objectives: </strong>Understanding and addressing how an individual's social, political, economic, and cultural context affects their ability to achieve optimal health is essential to designing and implementing interventions. Before evaluating two parenting programs, in partnership with four children's mental health organizations, we used the Health Equity Impact Assessment tool (HEIA) to identify groups that may experience unintended health impacts, as well as generated mitigation strategies to address these impacts.</p><p><strong>Methods: </strong>HEIA activities included a review of the published literature, a review of organizational documents, key informant interviews with staff (<i>n</i> = 12) and other related community service providers (<i>n</i> = 7), and a geographic information systems analysis. All sources of evidence were considered and analyzed using reflective thematic analysis. Summary reports were shared with all partners.</p><p><strong>Results: </strong>A range of groups were identified as at risk of experiencing unintended health impacts, including caregivers who are racialized, immigrants, Indigenous, living with mental health issues or addictions, dealing with intellectual challenges and/or low literacy levels, survivors of childhood trauma, single parent families, or families experiencing financial difficulties. Unintended health impacts were sorted into 6 main themes which fell under the overarching themes of accessibility of the programs and cultural appropriateness. Mitigation strategies as well as innovative strategies already being applied by participating organizations are discussed.</p><p><strong>Conclusion: </strong>Although this HEIA focused on parenting programs, the findings address equity issues applicable to the provision of a wide spectrum of children's mental health services.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"419-425"},"PeriodicalIF":2.6,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting Diversity, Equity, Inclusion, and Justice in Grantmaking for Health Care Research: A Pragmatic Review and Framework.","authors":"Zoe King, Cati Brown-Johnson, Alica Forneret, Daniel Yang, Elizabeth Malcolm, Daren R Ginete, Eunice Mercado-Lara, Donna M Zulman","doi":"10.1089/heq.2023.0263","DOIUrl":"10.1089/heq.2023.0263","url":null,"abstract":"<p><p>Funders of research have an opportunity to advance health equity and social justice by incorporating principles of diversity, equity, inclusion, and justice (DEIJ) in their approach to grantmaking. We conducted a pragmatic review to identify opportunities for grantmakers in the health care sector to integrate DEIJ in their funding activities. The resulting framework discusses recommendations within three phases as follows: (1) Organizational Context (i.e., initiate DEIJ efforts within the grantmaking organization, invest in community partnerships, and establish DEIJ goals), (2) Grantmaking Process (i.e., DEIJ-specific practices related to grant design, application, proposal review processes, and support for grantees), and (3) Assessment of Process and Outcomes (i.e., measurement, evaluation, and dissemination to maximize impact of DEIJ efforts). Throughout all grantmaking phases, it is critical to partner with and engage individuals and communities that have been historically marginalized in health care and research. In this article, we describe how adoption of framework practices can leverage grantmaking to advance DEIJ for communities, researchers, and projects.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"391-405"},"PeriodicalIF":2.6,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Racial Misclassification Among American Indian and Alaska Native Identity in Cancer Surveillance Data in the United States and Considerations for Oral Health: A Systematic Review.","authors":"Amanda J Llaneza, Alex Holt, Julie Seward, Jamie Piatt, Janis E Campbell","doi":"10.1089/heq.2023.0252","DOIUrl":"10.1089/heq.2023.0252","url":null,"abstract":"<p><strong>Introduction: </strong>Misclassification of American Indian and Alaska Native (AI/AN) peoples exists across various databases in research and clinical practice. Oral health is associated with cancer incidence and survival; however, misclassification adds another layer of complexity to understanding the impact of poor oral health. The objective of this literature review was to systematically evaluate and analyze publications focused on racial misclassification of AI/AN racial identities among cancer surveillance data.</p><p><strong>Methods: </strong>The PRISMA Statement and the CONSIDER Statement were used for this systematic literature review. Studies involving the racial misclassification of AI/AN identity among cancer surveillance data were screened for eligibility. Data were analyzed in terms of the discussion of racial misclassification, methods to reduce this error, and the reporting of research involving Indigenous peoples.</p><p><strong>Results: </strong>A total of 66 articles were included with publication years ranging from 1972 to 2022. A total of 55 (83%) of the 66 articles discussed racial misclassification. The most common method of addressing racial misclassification among these articles was linkage with the Indian Health Service or tribal clinic records (45 articles or 82%). The average number of CONSIDER checklist domains was three, with a range of zero to eight domains included. The domain most often identified was Prioritization (60), followed by Governance (47), Methodologies (31), Dissemination (27), Relationships (22), Participation (9), Capacity (9), and Analysis and Findings (8).</p><p><strong>Conclusion: </strong>To ensure equitable representation of AI/AN communities, and thwart further oppression of minorities, specifically AI/AN peoples, is through accurate data collection and reporting processes.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"376-390"},"PeriodicalIF":2.6,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racism as a Threat to Palestinian Health Equity.","authors":"Yara M Asi, Mienah Z Sharif, Bram Wispelwey, Nadia N Abuelezam, A Kayum Ahmed, Goleen Samari","doi":"10.1089/heq.2024.0027","DOIUrl":"10.1089/heq.2024.0027","url":null,"abstract":"<p><p>Between October 2023 and April 2024, more than 30,000 Palestinians were killed, and countless others injured, displaced, and traumatized, in the fifth major Israeli assault on the Gaza Strip since 2006. Recent events, along with the trajectory of events over the past 75 years, demonstrate that using a public health framework could help recognize racism as a structural and social determinant of Palestinian health. Using the principles of health equity, we show how Palestinian health inequities are rooted in settler colonialism and racism, amounting to violence and oppression against Palestinian Arabs as a racialized group, regardless of religion or citizenship. Structural racism should be recognized as a driver of Palestinian health inequities.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"371-375"},"PeriodicalIF":2.6,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Neighborhood Racialized Economic Segregation with Cardiometabolic Health and Cortisol in a Racially/Ethnically Diverse Sample of Children from Minneapolis-St. Paul.","authors":"Christopher P Carr, Allan D Tate, Amanda Trofholz, Junia N de Brito, Andrea N Trejo, Michael F Troy, Jerica M Berge, Alicia Kunin-Batson","doi":"10.1089/heq.2023.0246","DOIUrl":"10.1089/heq.2023.0246","url":null,"abstract":"<p><strong>Introduction: </strong>Past research shows that structural racism contributes to disparities in cardiometabolic health among racially/ethnically minoritized populations.</p><p><strong>Methods: </strong>This cross-sectional study examined the correlation between census tract-level racialized economic segregation and child health metrics among a racially and ethnically diverse cohort of 350 children (ages 6.5-13.8) from Minneapolis-St. Paul, MN.</p><p><strong>Results: </strong>A consistent cardiometabolic and cortisol outcome gradient was observed across the index of concentration at the extremes tertiles, such that health risk factors increased as tract privilege decreased.</p><p><strong>Conclusion: </strong>Racialized economic segregation was associated with less favorable child health outcomes, underscoring the potential importance of place-based interventions for promoting children's health.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"355-359"},"PeriodicalIF":2.6,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141622138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}